Holistic Balance Research Articles

Konseptualisasi Adventure-Based Counseling untuk Meningkatkan EcoWellness: Mengintegrasikan Alam dan Petualangan untuk Kesejahteraan Klien yang Holistik

The aim of this research describes a conceptual effort to improve clients' holistic EcoWellness through adventure-based counseling that is integrated with nature and adventure. Integrating Adventure-based Counseling activities with the concept of EcoWellness, namely appreciation, respect, admiration, and connectedness to nature, has been proposed as an effective framework for enriching the concept of counseling theory. The research method uses a literature review to review logically based on a comprehensive understanding of the conceptual framework of Adventure-based Counseling to improve EcoWellness. Research goes through six stages, namely (1) selecting and determining the topic; (2) developing tools for argumentation and conclusions from various concepts; (3) literature search to find sources relevant to the specified topic with the help of Mendeley Reference Manager to catalog and document information; (4) a literature survey was conducted to collect, organize, and analyze data that had been collected and documented in Mendeley Reference Manager; (5) criticizing the literature, producing responses to the research topic, a conceptual framework as a conclusion to form research objectives; and (6) writing a review, the review produces a document. To explore this concept, this research investigates the role of nature in strengthening humans' connection to the environment, as well as the positive impact of adventure in enhancing EcoWellness. The findings of this literature review highlight the importance of integrating nature and adventure in counseling to achieve clients' holistic balance. The theoretical implications of this conceptualization are discussed in the context of improving the quality of counseling services and a deeper understanding of humans' relationship with nature

Transferred Bias Uncovers the Balance Between the Development of Physical and Socioeconomic Environments of Cities

Evaluating the balance between a city’s physical and socioeconomic environmental development is crucial for creating sustainable and livable urban spaces. Although they might appear contradictory, they jointly support the comprehensive sustainable urban development strategy. Traditional methods usually focus on assessing this balance from a specific perspective, such as how neighborhood greenery shapes real estate value. Yet, they fail to deliver a holistic balance assessment in developing the physical and socioeconomic dimensions. To fill this gap, this study introduces a research framework that measures this balance through house prices based on transferred bias. Using house price as an indicator shaped by both physical and socioeconomic environments, the framework first constructs a series of deep learning models to estimate house prices through street view images for each city. These models capture the relationship between neighborhood appearance and house price. Second, by leveraging transfer inference, we introduce neighborhood appearance from one city into the model trained from another city. This process identifies the transferred bias, which is the disparity between inaccurate inference resulting from a mismatched neighborhood appearance and the trained model. Through transferred bias, we can quantify the differences in physical and socioeconomic environments across cities and evaluate the urban balances of these two environments. The results show that the transferred bias effectively quantifies the disparities among cities in physical and socioeconomic environments, thereby facilitating further investigation into the urban balance between these two environments.

Models for Sustainable Open Access Land Management That Integrate Economic, Social, and Environmental Balance

This study delves into the intricate process of crafting a sustainable model for managing open access land, utilizing an integrative approach that employs structural equation modeling (SEM) analysis while broadening the conventional triple bottom line framework. By amalgamating the economic, social, and environmental dimensions of the triple bottom line with the governance variables inherent in the pentuple bottom line concept, this approach aims to achieve a more nuanced and holistic balance in the management of open access land. Through a meticulous blend of primary and secondary data collection methods, the study employs SEM analysis to scrutinize the intricate interplay between variables representing each dimension. The findings of this research shed light on the intricate mechanisms through which open access land management can be guided toward a more comprehensive sustainability paradigm, enriched by the multifaceted considerations encapsulated within the pentuple bottom line model. The ramifications of these revelations extend far beyond academic discourse, advocating for the adoption of a more all-encompassing model in open access land management practices, thereby fortifying collective efforts toward achieving holistic sustainable development objectives.

Perbandingan Sistem Ekonomi dan Ciri Utama Ekonomi Syari’ah

This research aims to provide in-depth knowledge about the fundamental differences between conventional economic systems and the characteristics of sharia economics. This research methodology is a literature review research which provides output to existing data. This research data has implications for the direction of society and the economy as a whole. Based on the conclusions of this research, the fundamental difference between conventional economics and Islamic economics lies in the view of rationality, economic goals, emphasis on needs, and consumer and producer orientation. In Islamic economics, it is important to achieve holistic balance in the material and spiritual groups to obtain prosperity on earth and in the afterlife

Gastrointestinal sistem kanaması sebebiyle yatan hastalarda akılcı ilaç kullanımı ve geleneksel tamamlayıcı tıp kullanımının incelenmesi

AIM: The aim of this study was to determine the knowledge levels of rational drug use, the attitudes to traditional and complementary medicine, and the relationship between these in patients admitted to the Internal Medicine Clinic because of gastrointestinal system bleeding. 
 METHOD: This descriptive, cross-sectional study was conducted with 124 patients hospitalised in the Internal Medicine Clinic of a training and research hospital with a diagnosis of gastrointestinal bleeding between 01.06.2022 and 01.10.2022.
 An Information Form including demographic and clinical characteristics, the Rational Drug Use Scale (RDUS), and the Complementary, Alternative, and Conventional Medicine Attitudes Scale (CACMAS) were applied to the patients. The data obtained were analyzed statistically using SPSS vn. 23.0 software. 
 RESULTS: For the whole sample of patients hospitalised with a diagnosis of gastrointestinal system bleeding, the mean RDUS points were determined to be 19.8±4.17 and the mean total CACMAS points were 96.76±15. In the subscales of the CACMAS, the mean points were determined to be 28.15±9.42 for philosophical congruence with complementary medicine, 23.23±10.39 for dissatisfaction with conventional medicine, and 45.38±8.18 for holistic balance. 
 The RDUS points were found to be significantly higher in females (20.33±4.37, p:0.04), patients with a good income status (22.17±4.02, p:0.03) and those who did not use painkillers (21.21±4.00, p:0.01) compared to other subgroups. The CACMAS subscale mean points for philosophical congruence with complementary medicine were determined to be significantly higher in males (29.77±9.52, p:0.03), patients who were single (36.33±9.06, p:0.002), and those who used anticoagulants (32.95±10.77, p: 0.04). The dissatisfaction with conventional medicine subscale points were determined to be significantly higher in females (26.04±9.74, p: 0,03), patients with a low income (30±15.17, p: 0.03) and those who used painkillers (26±10.67, p:0.01), and the holistic balance points were determined to be significantly higher in females (47.24±7.33, p: 0.02) and those who used medication regularly (46.49±8.34, p:0.02) compared to other sub-groups. A statistically significant negative correlation was found between rational drug use and dissatisfaction with conventional medicine (r=-0.381, p

Psychosocial well-being in Long-Term Care in the Wake of COVID-19: Findings from a Qualitative Study in New Zealand

Drawing on Mason Durie’s (1985) New Zealand Whare Tapa Whā model of health (spiritual, emotional, physical, and family domains), the goal was to link a model of well-being with the lived reality for long-term care residents and bereaved family members during COVID-19. Interviews were conducted with five residents and six family members of previous residents of one long-term care in one urban centre between July and September 2020. The increased demands imposed by the pandemic highlighted the gaps in well-being for residents and families. In particular, the inability to connect with family during COVID-19 restrictions reduced perceptions of well-being for residents. Study findings indicate that the provision of well-being for older adults and families in long-term care extends beyond the narrow bounds of the biomedical model. The Whare Tapa Whā model provides a valuable framework describing the holistic balance needed between the four health domains.

I Did You a Favor By Taking Your Work: Reconsidering the Harm-Based Approach To the Fourth Fair Use Factor

American copyright law is predominantly utilitarian. Fair use—codified to promote copyright’s utilitarian goals—has emerged as one of the most nebulous doctrines in American law. This is partially by design. Passing the Copyright Act of 1976 (the “Act”), Congress sought to endorse “the purpose and general scope of the judicial doctrine of fair use,” but made clear that “there is no disposition to freeze the doctrine in the statute, especially during a period of rapid technological change.” This judicial deference—combined with the case-by-case nature of fair use determinations—has led to evolving and inconsistent applications of section 107.
 Interpretation of section 107(4), which instructs courts to consider “the effect of the use upon the potential market for or value of the copyrighted work,” is illustrative. Though a plain reading of section 107(4) leaves room for consideration of all market effects, most courts and commentators agree that the inquiry into this factor concerns only deleterious effects on the copyright owner’s actual or potential markets. Some have expressed hostility toward consideration of positive market effects on the ground that an infringing use that might improve sales of a copyrighted work is also likely to invade the market for derivative works.
 In limited circumstances, courts and commentators have recognized the relevance of an unauthorized use providing financial gain for a copyright holder. In Authors Guild, Inc. v. Google Inc., Judge Chin indicated that Google Books increased exposure and sales for the copyright holders, concluding that “the fourth factor weighs strongly in favor of a finding of fair use.” While the Second Circuit declined to adopt Judge Chin’s explicit reasoning, Authors Guild remains a powerful endorsement of the plain reading of section 107(4). In Google LLC v. Oracle Am., Inc., the Supreme Court indicated that analysis of the fourth factor should weigh public benefits against private harms, endorsing a more holistic balancing of interests. In the wake of a reinvigorated fourth factor, it is worth reassessing whether economic benefits from infringement have any place in the market impact inquiry.
 This Note addresses the current status of market benefits: monetary gains conferred upon a copyright holder by a third party’s unauthorized use of a copyrighted work. While courts are still unwilling to treat market benefits as dispositive, they are moving away from the view that the fourth factor concerns only market harm. Expanded analysis of a fourth factor now balances private economic effects, public benefits, and in some cases, non-monetary concerns related to the value of a work. Market benefit proponents assert that their inclusion is more in line with the text and history 1976 Act, as well as the overall goals of copyright. Further, weighing market benefits against market harms helps to address problems related to circularity.
 This Note considers the viability of market benefits as both a dispositive and a relevant component of fourth factor interpretation. Part I provides a basic overview of the traditional approach to the fourth factor before defining and distinguishing between different types of market benefits. Part II analyzes recent caselaw acknowledging market benefits and proposes a framework for proving market benefits as part of a reinvigorated fourth factor. Part III addresses the viability of market benefit arguments across different sectors of copyrighted works and the possible implications of increased acceptance. It concludes that, despite enhanced recognition, market benefits still lack widespread applicability and are unlikely to change the outcome of any present fair use determination.

Five-Factor Framework: A New Approach to Analyzing Public Benefits in Fair Use Cases

Fair use is among “the most troublesome [doctrines] in the whole law of copyright.” Despite being one of the primary defenses against a claim of copyright infringement, the doctrine is confusingly unpredictable, providing copyright users little ex ante certainty about the lawfulness of their actions. Unfortunately, the Supreme Court’s latest fair use pronouncement may only further muddle the doctrine.
 In Google, LLC v. Oracle America, Inc., the Supreme Court accepted Google’s fair use defense for its appropriation of Oracle’s copyrighted code. In reaching that conclusion, Justice Breyer made a few unusual moves in his majority opinion. First, he “sidestep[ped]” the threshold question of the allegedly copyrighted work’s copyrightability. Second, he contemplated the four fair use factors out of their statutory order. Finally, his analysis of the fourth factor incorporated public benefits as an unconventional market effect. This Note argues that, of these jurisprudential choices, the last—explicit recognition of public benefits’ relevance to fair use—is likely to have an outsize impact on future cases. It further contends that Justice Breyer’s method for incorporating public benefits will negatively affect the clarity and transparency of these future fair use decisions. Public benefits are relevant to courts’ ultimate equitable fair use decisions, but courts must nevertheless accord the statutory considerations their due weight by engaging in the focused, factor-by-factor discussions of them that Congress provided for.
 While the public may benefit from a challenged use, “public benefits”—as Justice Breyer used the term—do not bear on the fourth fair use factor as codified by Congress. The fourth factor directs courts to consider “the effect of the use upon the potential market for or value of the copyrighted work.” Courts analyze this factor by investigating whether the use usurps the original work’s primary market or licensing opportunities, as well as whether the use creates a new market for the original work. “Public benefits,” meanwhile, represent non-competitive contributions to social welfare. Public benefits may include facilitating access to copyrighted works (through providing access to new users or making already-authorized users’ access more efficient); supporting the challenged user’s broader, public-oriented goals; or “promot[ing] or . . . protect[ing] the creative process.” In Oracle, the challenged use facilitated third parties’ creation of new copyright-eligible works. In any given case, therefore, public benefits represent externalities that the public is set to receive notwithstanding the challenged use’s effect on the original author’s incentives to create or its own creative expression. Justice Breyer’s public benefits analysis—necessary though it is to resolving fair use cases equitably—therefore departed from the fourth factor’s ambit. If lower courts follow his lead, the relevance of fair use’s statutory language will decrease. And if the statutory framework stops guiding fair use analysis, copyright owners and users will face greater uncertainty when predicting whether any given use will be fair, for they will no longer have a means to predict courts’ methodologies, let alone what decisions will issue.
 Fair use requires contextual analysis within a standardized and coherent framework. To produce greater transparency and predictability, this Note proposes reorganizing fair use analysis to isolate and incorporate public benefits as a fifth factor. Part I uses a potted history of fair use to argue that the defense exists to ensure the public reaps the maximum benefits from copyrighted works. Part II contends that existing approaches to fair use fail to adequately value public benefits deriving from challenged uses of copyrighted works. Part III proposes the five-factor framework, whereby courts would investigate public benefits as a fifth factor and then incorporate their findings into fair use’s ultimate holistic balancing. Finally, Part IV applies the new framework to Oracle to demonstrate the virtues of clearer reasoning.

A grounded theory study of alarm fatigue among nurses in intensive care units

ObjectivesThe aim of this study was to explore the process of how nurses experienced and dealt with alarm fatigue in intensive care units based on Iranian nurses' perceptions and experiences. BackgroundAlarm fatigue is the overstimulation of senses due to the constant ringing of alarms in intensive care units. It is associated with nurses’ desensitization to critical alarms that can directly influence patient safety and quality of care. MethodsA qualitative exploratory study using the grounded theory approach by Strauss and Corbin was carried out. Participants were 20 nurses working in intensive care units. The sampling process was started purposively and continued theoretically. Data were collected using semi-structured, in-depth, and individual interviews and continued to data saturation. The constant comparative analysis approach was used consisting of the following steps: open coding, developing concepts, analysing the context, entering the process into data analysis, integrating categories. FindingsThe participants' main concern in the exposure to alarm fatigue was ‘threat to personal balance’. The core category in this research was ‘trying to create a holistic balance’, which reflected a set of strategies that the nurses consistently and continuously used to deal with alarm fatigue and consisted of four main categories as follows: ‘smart care’, ‘deliberate balancing’, ‘conditional prioritisation’, and ‘negligent performance’. Threat to personal balance was strengthened by ‘inappropriate circuit of individual roles’, ‘distortion of the organisational structure’, and ‘insecurity of the infrastructure’. The consequences of this process was harm to the patient, burnout among nurse, and damage to the healthcare organisation. ConclusionsThe research findings have practical implications for healthcare management, policymaking, nursing education, research, and clinical practice. Mitigating staff shortages, improving staff competencies, enhancing nurses’ authority for responding to alarms, modifying care routines, improving the physical environment, and removing problems related to alarm equipment can prevent alarm fatigue and its unappropriated consequences.

Efektivitas Intervensi Relaksasi Imaginasi Terbimbing Terhadap Penurunan Kecemasan dan Nyeri pada Pasien Paliatif

Anxiety and pain are problems that often occur in patients with chronic diseases. One of the goals of palliative care is to relieve physical symptoms that are felt and other things that make physical and psychological stress. Alternative and complementary medicine approaches can be an option for palliative patients and families where conventional treatment has not been able to reduce or relieve the symptoms they feel. : Complementary therapies can be provided to patients receiving palliative care, to integrate a multi-professional palliative approach. The development of effective intervention selection is very important for the success of its treatment. Guided imagination is one of the complementary therapies that can provide physical and psychological benefits. Therefore, the purpose of this literature study was to determine the effectiveness of guided imaginary relaxation in reducing anxiety and pain levels in palliative patients. Methods: This literature review was compiled using the databases of EBSCOHost, Clinical Key Nursing and Sage Journal. Four articles were obtained that were following the randomized control randomization research method. Results: After further analysis of the four articles, guided imagination techniques accompanied by music were more effective in reducing pain and anxiety and could increase feelings of well-being when combined with other complementary therapies such as progressive muscle relaxation and hand massage. Conclusion: Within the various complementary therapies available, each aims to develop a holistic balance for the individual by enhancing physical, psychological, and spiritual well-being. Guided imagery helps patients by diverting their attention from the disease, its associated side effects, negative thoughts, and emotions, and focusing instead on pleasant things.

Life Cycle Assessment of Concrete Pavement Rehabilitation: A Romanian Case Study

The most well-known and used evaluation system to determine the life cycle of a product, is the life cycle assessment (LCA). In Europe, the use of the life cycle assessment (LCA) to assess the environmental performance of products is becoming commonplace, which is why substantial efforts have been made in the last two decades to develop new life cycle assessment (LCA) methodologies and software. This paper evaluates the life cycle assessment (LCA) for the rehabilitation of a national road sector in Romania. The biggest ecological problem facing mankind is the effect of global warming and climate change associated with this phenomenon, due to the increase of the concentration of pollutants to the atmosphere, and this paper presents the results of the life cycle assessment (LCA) based on a cradle-to-gate approach. For this case study, were used three rehabilitation alternatives. These alternatives and the existing pavement structure were analysed using the GaBi software, Ganzheitlichen Bilanzierung (German for holistic balancing), to assess the environmental impact of global warming, the stratospheric impact of ozone, and the impact on human health. The results obtained in this study illustrate the importance of a life cycle assessment approach for evaluating the sustainability for different designs and for the construction of road rehabilitation options.

Listen but Don’t Ask Question: Hawaiian Slack Key Guitar across the TransPacific by Kevin Fellezs

Reviewed by: Listen but Don’t Ask Question: Hawaiian Slack Key Guitar across the TransPacific by Kevin Fellezs James Revell Carr Listen but Don’t Ask Question: Hawaiian Slack Key Guitar across the TransPacific. By Kevin Fellezs. Durham, NC: Duke University Press, 2019. [xvii, 316 p. ISBN 9781478005995 (hardcover), $104.95; ISBN 9781478006718 (paperback), $28.95; ISBN 9781478007418 (e-book), price varies.] Illustrations, glossary. Maps of the earth typically cut the Pacific Ocean in half, literally marginalizing one third of the planet’s surface and the people who have inhabited and explored that vast region for millennia. In his recent book, Listen but Don’t Ask Question: Hawaiian Slack Key Guitar across the TransPacific, Kevin Fellezs seeks to recenter the Pacific and one of its most well-known music traditions. Moving from Hawaii to cultural outposts in California and Japan, Fellezs examines the ways in which players of the Hawaiian guitar style, kı̄ hō‘alu, more commonly known as “slack key guitar,” have represented Hawaiian-ness through musical performance. Fellezs uses his own complex genealogy, with ancestors from Hawaii, Japan, Portugal, and the Philippines, as a metaphor for the complicated multicultural history of Hawaiian music. He further complicates his own relationship to Hawaiian culture by discussing his upbringing in the San Francisco Bay Area, as part of a Hawaiian ‘ohana (family) in diaspora, which leads him to ask, “What constitutes Hawaiian belonging?” (p. 2). And furthermore, “How do diasporic Hawaiians fit in any discussion of indigeneity and cultural performance and performativity? How might Japanese guitarists reproduce or challenge the long history of cultural appropriation, commodification, and non-Hawaiian indigenization accomplished through ‘Hawaiian at heart’ rhetoric?” (p. 3). In order to answer these questions, Fellezs employs four Kanaka Maoli (indigenous Hawaiian) terms (p. 7) representing central concepts of this musical practice: kuleana (prerogative or responsibility), aloha (love), ‘ohana (extended family), and pono (holistic balance). One of the most fascinating dimensions of the book is the author’s discussion of how key Hawaiian words such as these were manipulated by Christian missionaries when they began to establish English-language translations for Hawaiian concepts, using purposeful mistranslation to justify their own appropriation and exploitation of Hawaiian lands and cultural properties. By reorienting these Hawaiian terms and employing indigenous Hawaiian concepts as the foundation for his critical approach to the topic, Fellezs clearly articulates the values and aesthetics of a music culture with distinct ways of belonging that nevertheless has transcended its ethnic and [End Page 426] geographic origins to become a truly global form of popular music. In chapter 1, Fellezs describes an oral/aural musical pedagogy that rings familiar to participants in many folk-music genres, in which achieving the proper kind of feeling is prioritized over technical mastery (p. 77). It becomes clear through the author’s analysis that perhaps the most crucial element in the effective performance of kı̄ hō‘alu is achieving the right kind of feeling, known among slack key players as the “nahenahe (sweet, gentle, and melodious) aesthetic” (p. 19). While there is much debate in slack key circles over whether or not one can learn to play with this feeling regardless of one’s personal connection to the Hawaiian islands, Fellezs shows that this nahanahe aesthetic is one of Hawaii’s most recognizable musical exports, influencing musicians on both sides of the Pacific and beyond. Chapter 1 also introduces the godfather of modern slack key guitar, Gabby Pahinui, who, along with ukulele virtuoso and historian Eddie Kamae and their group, Sons of Hawaii, was a key figure in the Second Hawaiian Renaissance. Pahinui repopularized the slack key genre and became a mentor for many other Hawaiian musicians who propagated and progressed the music in the late twentieth century, like Sonny Chillingworth, Ledward Kaapana, Keola and Kapono Beamer, Raymond Kane, and Gabby Pahinui’s son, Cyril. Fellezs briefly addresses the lack of women in the discourse around slack key, pointing to female guitarists like Noelani Māahoe, who released albums of slack key music prior to the Second Hawaiian Renaissance, as evidence that the role of women in the development, transmission, and preservation of the Hawaiian slack key tradition has been badly undervalued. He speculates that although...

Sağlık Hizmetleri Meslek Yüksekokulu Öğrencilerinin Geleneksel ve Tamamlayıcı Tıp ile İlgili Tutum ve Bilgi Düzeylerinin Belirlenmesi: Tanımlayıcı Araştırma

Objective: The aim of this descriptive study is to determine the knowledge and attitudes of the health services vocational school students about conventional and complementary medicine practices (CCMP). Material and Methods: The study included students from Bolu Abant İzzet Baysal University Mehmet Tanrıkulu Vocational School of Health Services. The data were collected online between November-December 2021 through the socio-demographic data form, Complementary, Alternative, Conventional Medicine Attitude Scale (CACMAS), and the CCMP information form. Results: The mean CACMAS score of the students (111.60±13.77) was found to be high. In general, knowledge level of students about CCMP practices are insufficient. The most and the least known CCMP methods among students are hypnosis (76.9%) and prolotherapy (88.3%), respectively. The philosophical congruence with complementary and alternative medicine in female students were higher than male (p=0.019). Dissatisfaction of second grade students with conventional medicine was found to be more than first grade students (p=0.005). The mean scores of the scale (p=0.002), philosophical congruence with complementary and alternative medicine (p=0.026) and the holistic balance sub-scales (p=0.024) of the students who used CCMP were found to be higher than the others. A very weak positive correlation was found between the age of the students and the scale mean score (r=0.15; p<0.01). On the other hand, a weak positive correlation was found between the age of students and dissatisfaction with conventional medicine mean score (r=0.25; p<0.01). Conclusion: Health services vocational school students have positive attitudes towards CCMP, but their level of knowledge is insufficient.

Mobility Restrictions and E-Commerce: Holistic Balance in Madrid Centre during COVID-19 Lockdown

COVID-19 has brought about a substantial change in urban mobility, as well as an unprecedented increase in e-commerce throughout the world due to the emergence of new ways of shopping and consumption habits. In this context, urban logistics plays a crucial role in the triple bottom line of sustainability. The present document establishes a holistic vision of the problem aiming to (i) measure and compare the traffic generated in the Madrid Central area (low-emission zone) during the periods before and after the pandemic, and (ii) quantify e-commerce orders made by residents, as well as the Light Commercial Vehicles (LCV) required to deliver these parcels, measuring their environmental impact. The results show that road traffic in the Madrid Central area decreased by approximately 2/3 compared to normal levels and 1/2 in the case of LCVs. With regards to e-commerce, the number of parcels delivered doubled. This fact entailed an increase in the number of LVCs dedicated to package delivery in the central district and more pollution, but to a lesser extent than the growth of e-commerce. The challenge faced by urban logistics in the post-Covid era is managing to blend new mobility within large cities with the high volumes of e-commerce deliveries demanded by residents.

Analogous Systems Principles and Concepts of Traditional Chinese Medicine and Congruence Couple Therapy

Open access article. Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence (CC BY-NC-SA 4.0) applies

Risk predictive value of two kinds of scales on skin postocclusive reactive hyperemiain ICU patients

Objective To explore the predictive value of Cubbin & Jackson Scale and Braden scale on skin postocclusive reactive hyperemia in intensive care unit (ICU) patients. Methods From June 2016 to June 2018, we selected 150 surgical ICU at Xuanwu Hospital of Capital Medical University as subjects by convenient sampling. The Braden Scale and Cubbin & Jackson Scale were used to evaluate the risk of skin postocclusive reactive hyperemia in ICU within 14 days. We compared the sensitivity, specificity, positive predictive value and negative predictive value of two kinds of scale based on the best critical values. The areas under the receiver operating characteristic (ROC) curve were used to compare the predictive value for reactive hyperemia of two kinds of scale. Results Taking the concept of reactive hyperemia in Science and practice of pressure ulcer management as the gold standard, there were 46 (30.6%, 46/150) cases with reactive hyperemia and 6 (13.0%, 6/46) cases with pressure ulcer. The best critical values of Cubbin & Jackson scale and Braden scale were 29 and 13 respectively. The sensitivity, specificity, positive predictive value, negative predictive value and areas under the ROC of Cubbin & Jackson Scale and Braden Scale were 90%, 63%, 68%, 97%, 0.875 and 96%, 43%, 35%, 94%, 0.537 respectively. Conclusions The sensitivity in reactive hyperemia of Cubbin & Jackson Scale is lower, but the the holistic balance is higher than that of Braden scale which shows that the predictive value is higher than that of Braden. Key words: Intensive care unit; Reactive hyperemia; Pressure ulcer; Braden Scale; Cubbin & Jackson Scale; Prediction

Design of a Completely New First Year Engineering Program at the University of Saskatchewan – Part II

Over the last three years, the University of Saskatchewan’s College of Engineering has embarked upon a complete redesign of its first year common program. This project started from a blank slate and posed the question, "If we could design any first year program that we wanted, what would we create?" The goal is to offer a first year program that excites, engages, inspires, and holistically prepares students for learning in subsequent years. At CEEA 2018, Phase I of this project was reviewed with a focus on the content of the new first year. This year, the focus is on the structure of the proposed program and how it aims to satisfy programmatic design objectives. &#x0D; The proposed first year program is highly modular, allowing for more intentional uses of time during the academic year. Course duration and intensity vary and are selected to best serve student learning, rather than conform to the traditional academic schedule. To provide more timely and targeted feedback, summative assessments occur throughout each term allowing course scheduling to extend into the traditional end-of-term final exam period. This paper presents the current structural design of the new first year and the rationale for its significant features.&#x0D; Some of the program design objectives that have been facilitated by this structure include:&#x0D; • strategic sequencing of learning with opportunities to integrate and reinforce essential skills,&#x0D; • multiple, individualized opportunities for students to stumble and recover,&#x0D; • holistic balancing of content and pacing for better student wellbeing, and&#x0D; • comprehensive, well-timed exposure to wide-ranging programmatic choices for students.&#x0D; Throughout this project, the program structure has evolved continuously. This paper will describe the development process, the challenges faced in that process, and the lessons learned. The paper will conclude by describing the current status of the project, and the focus of work currently being undertaken to prepare for implementation.&#x0D;

Experimental analysis of self-organized structure and transport on the magnetospheric plasma device RT-1

Dipole plasma exhibits strong heterogeneities in field strength, density, temperature and other parameters, while maintaining a holistic balance. Our study of the internal structures reveals the fundamental self-organizing mechanisms operating in their simplest realization (as commonly observed in astronomical systems). Three new findings are reported from the RT-1 experiment. The creation of a high-energy electron core (similar to the radiation belts in planetary magnetospheres) is observed for the first time in a laboratory system. High-energy electrons (3–15 keV), produced by electron cyclotron heating, accumulate in a ‘belt’ located in the low-density region (high-beta value ~1 is obtained by increasing the high-energy component up to 70% of the total electrons). The dynamical process of the ‘up-hill diffusion’ (a spontaneous mechanism of creating density gradient) has been analyzed by perturbing the density by gas injection. The spontaneous density formation in the laboratory magnetosphere elucidates the self-organized plasma transport relevant to a planetary magnetosphere. The coherence-imaging spectroscopy visualized the two-dimensional profiles of ion temperature and flow velocity in the ion cyclotron resonance frequency heating. The ion temperature and flow were enhanced globally, and particularly along the magnetic field lines near the levitation magnet. These results advance our understanding of transport and self-organization not only in dipole plasmas, but in general magnetic confinement systems relevant to fusion plasmas.

Holistic assessment of solid wastes and their environmental impacts in Osogbo city, Southwestern Nigeria with the application of GaBi6 modeling tool

Environmental impacts and attendant nuisance of solid wastes escalate in the 21st Century. Effective management of the wastes in a holistic manner is a proven way out of the menace. This research focuses on accessing the life cycle of solid wastes in Osogbo. The main objective is to evaluate the physical and chemical constituents of the wastes and determine their best disposal method in the study area. In the study, wastes were collected over a period of 2 weeks, wastes composition was determined for the randomly selected residential buildings, and the per capital waste generation rate was evaluated for the area. Potable gas detectors were used to detect and measure the gases present at this dumpsite. The emission of gases and energy consumption was evaluated using the methodology of life cycle in calculating life cycle inventory of the waste strategies. The measured gases include; Sulphur (IV) oxide (SO2), carbon monoxide (CO), carbon (iv) oxide (CO2), ammonia (NH4). The Tool for the Reduction and Assessment of Chemical and other Environmental Impacts (TRACI) of the United States Environmental Protection Agency and the Methodology of the Centre for Environmental Studies (CML) of the University of Leiden are the two approaches applied as provided for in the GaBi6 (Holistic Balancing) Life Cycle Assessment (LCA) software database, to classify and characterize environmental impacts of municipal wastes in Osogbo. The Impact Indices measured from both scenarios were: Global Warming Potential (GWP), Acidification Potential (AP), Eutrophication Potential (EP) and Ozone Layer Depletion Potential (ODP). For the Life Cycle Impact Assessment (LCIA), two waste management scenarios were developed and compared using GaBi6 software. Scenario one involves collection, transportation and incineration, while Scenario 2 ends with landfilling. Findings showed that the overall mean percent (%) wastes composition for paper, biodegradable, plastic, glass, metal, wood and textile were respectively found to be 4.32, 67.53, 5.07, 4.90, 6.54, 8.74 and 2.90. The per capita waste generation in the study area was found to be 1.09 kg/capita/day. From the results of LCIA methods studied using the ODP index, Scenario one with the TRACI method gives the total values for GWP, AP, EP, ODP as 4.18, 1.08, 1.392E-4, 3.147E-8 respectively. With the CML method, the values are 4.18, 1.3E-3, 3.771E-4, 2.878E-8 respectively. The respective results from scenario two with the TRACI method and CML methods showed total values for GWP, AP, EP, ODP as 9.64, 0.112, 3.108E-3, 1.447E-11 and 9.64, 1.77E-3, 7.247E-3, 1.361E-11. It is concluded that of the two management scenarios considered, landfilling of wastes is more environmentally friendly as compared to incineration, and is therefore recommended for use in the study area.

Total Wealth Allocation: Liquidity, Longevity, and Legacy

In general, households use old technology for asset allocation decisions. Target-risk portfolio models are pervasive across the industry, and risk-profile questionnaires continue to form the foundation for strategic asset allocation decision-making. Better technology would utilize liability relative optimization and a holistic balance sheet and incorporate behavioral finance considerations. However, these concepts have not been integrated into most practitioners’ businesses, even though the core work on each was completed 20–30 years ago. The authors propose a scalable, total wealth model for integrating liability relative optimization into households’ portfolios. The basis for the model is an asset segmentation approach that refl ects the nuances of a households’ balance sheet and future objectives and enables liability relative optimization and total wealth considerations to be applied appropriately. <b>TOPICS:</b>Portfolio theory, wealth management, in portfolio management, performance measurement